TRIAL OF EUGLYCEMIA IN CARDIAC SURGERY (TECS): A RANDOMIZED CLINICAL TRIAL

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 为了评估儿科重症监护患者严格控制血糖的效果，我们提出了一项心脏手术患者的随机对照研究。入选的患者将被随机分为两组，一组是在心脏重症监护病房(CICU)接受胰岛素静脉注射的严密血糖控制组，即“正常血糖组”；另一组是不接受胰岛素注射治疗的高血糖的标准护理组，即“对照组”。为了严格控制血糖，同时确保我们干预的安全性，将使用连续的血糖监测仪来预防和及时检测两组中的任何低血糖。基于这一人群中应激性高血糖的高发生率，以及严格控制血糖的危重成人患者发病率的大幅下降，我们假设我们的干预可以降低医院感染发生率和CICU住院时间，并改善那些接受治疗以维持正常血糖的儿童的心功能和营养指标。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. To evaluate the efficacy of strict glycemic control in pediatric critical care patients we propose a randomized, controlled study in cardiac surgery patients. Enrolled patients will be randomized to either tight glycemic control post-operatively in the cardiac intensive care unit (CICU) with intravenous insulin infusions, the "euglycemia group", or to standard care where hyperglycemia is not treated with insulin infusions, the "control group." To allow tight glycemic control while ensuring safety of our intervention, continuous glucose monitors will be used to prevent and promptly detect any hypoglycemia in both groups. Based on the high incidence of stress hyperglycemia in this population and the dramatic decrease in morbidity in critically ill adult patients with tight glycemic control, we hypothesize that our intervention may decrease nosocomial infection incidence and CICU length of stay, and in addition improve both cardiac function and nutritional indices in those children treated to maintain euglycemia.